MEDICINE AND PHARMACY FACULTY

UNIVERSITY OF ORADEA

EPIDEMIOLOGY

ByCONSTANTA TURDA MD

History of

Epidemiology

Hippocrates (460-377 BC)

On Airs Waters and Places

Idea that disease might be associated with physical environment

Thomas Sydenham (1624-1689)

Recognized as a founder of clinical medicine and epidemiology

Emphasized detailed observations of patients amp accurate recordkeeping

James Lind (1700rsquos)

Designed first experiments to use a concurrently treated control group

Edward Jenner (1749-1823)

Pioneered clinical trials for vaccination to control spread of smallpox

Jenners work influenced many others including Louis Pasteur who developed vaccines against rabies and other infectious diseases

Ignas Semmelweis (1840rsquos)

Pioneered handwashing to help prevent the spread of septic infections in mothers following birth

John Snow (1813-1858)

Father of epidemiology

Careful mapping of cholera cases in East London during cholera epidemic of 1854

Traced source to a single well on Broad Street that had been contaminated by sewage

History of Epidemiology (Contrsquod)

bull Vital Statistics John Graunt (1620-1674) William Farr (1807-1883)

bull Occupational medicineamp Industrial Hygiene

Bernardino Ramazzini (1633-1714)

bull Role of carriers in transmission Typhoid Mary amp George Soper

Typhoid Mary amp George Soper Mary Mallon a cook responsible for most famous outbreaks of

carrier-borne disease in medical history Recognized as carrier during 1904 NY typhoid fever epidemic When source of disease was traced Mary had disappeared

only to resurface in 1907 when more cases occurred Again Mary fled but authorities led by George Soper caught

her and had her quarantined on an island In 1910 the health department released her on condition that

she never accept employment involving the handling of food Four years later Soper began looking for Mary again when two

new epidemics broke out Mary had worked as a cook at both places

She was found and returned to North Brother Island where she remained the rest of her life until a paralytic stroke in 1932 led to her slow death six years later

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

History of

Epidemiology

Hippocrates (460-377 BC)

On Airs Waters and Places

Idea that disease might be associated with physical environment

Thomas Sydenham (1624-1689)

Recognized as a founder of clinical medicine and epidemiology

Emphasized detailed observations of patients amp accurate recordkeeping

James Lind (1700rsquos)

Designed first experiments to use a concurrently treated control group

Edward Jenner (1749-1823)

Pioneered clinical trials for vaccination to control spread of smallpox

Jenners work influenced many others including Louis Pasteur who developed vaccines against rabies and other infectious diseases

Ignas Semmelweis (1840rsquos)

Pioneered handwashing to help prevent the spread of septic infections in mothers following birth

John Snow (1813-1858)

Father of epidemiology

Careful mapping of cholera cases in East London during cholera epidemic of 1854

Traced source to a single well on Broad Street that had been contaminated by sewage

History of Epidemiology (Contrsquod)

bull Vital Statistics John Graunt (1620-1674) William Farr (1807-1883)

bull Occupational medicineamp Industrial Hygiene

Bernardino Ramazzini (1633-1714)

bull Role of carriers in transmission Typhoid Mary amp George Soper

Typhoid Mary amp George Soper Mary Mallon a cook responsible for most famous outbreaks of

carrier-borne disease in medical history Recognized as carrier during 1904 NY typhoid fever epidemic When source of disease was traced Mary had disappeared

only to resurface in 1907 when more cases occurred Again Mary fled but authorities led by George Soper caught

her and had her quarantined on an island In 1910 the health department released her on condition that

she never accept employment involving the handling of food Four years later Soper began looking for Mary again when two

new epidemics broke out Mary had worked as a cook at both places

She was found and returned to North Brother Island where she remained the rest of her life until a paralytic stroke in 1932 led to her slow death six years later

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Hippocrates (460-377 BC)

On Airs Waters and Places

Idea that disease might be associated with physical environment

Thomas Sydenham (1624-1689)

Recognized as a founder of clinical medicine and epidemiology

Emphasized detailed observations of patients amp accurate recordkeeping

James Lind (1700rsquos)

Designed first experiments to use a concurrently treated control group

Edward Jenner (1749-1823)

Pioneered clinical trials for vaccination to control spread of smallpox

Jenners work influenced many others including Louis Pasteur who developed vaccines against rabies and other infectious diseases

Ignas Semmelweis (1840rsquos)

Pioneered handwashing to help prevent the spread of septic infections in mothers following birth

John Snow (1813-1858)

Father of epidemiology

Careful mapping of cholera cases in East London during cholera epidemic of 1854

Traced source to a single well on Broad Street that had been contaminated by sewage

History of Epidemiology (Contrsquod)

bull Vital Statistics John Graunt (1620-1674) William Farr (1807-1883)

bull Occupational medicineamp Industrial Hygiene

Bernardino Ramazzini (1633-1714)

bull Role of carriers in transmission Typhoid Mary amp George Soper

Typhoid Mary amp George Soper Mary Mallon a cook responsible for most famous outbreaks of

carrier-borne disease in medical history Recognized as carrier during 1904 NY typhoid fever epidemic When source of disease was traced Mary had disappeared

only to resurface in 1907 when more cases occurred Again Mary fled but authorities led by George Soper caught

her and had her quarantined on an island In 1910 the health department released her on condition that

she never accept employment involving the handling of food Four years later Soper began looking for Mary again when two

new epidemics broke out Mary had worked as a cook at both places

She was found and returned to North Brother Island where she remained the rest of her life until a paralytic stroke in 1932 led to her slow death six years later

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Thomas Sydenham (1624-1689)

Recognized as a founder of clinical medicine and epidemiology

Emphasized detailed observations of patients amp accurate recordkeeping

James Lind (1700rsquos)

Designed first experiments to use a concurrently treated control group

Edward Jenner (1749-1823)

Pioneered clinical trials for vaccination to control spread of smallpox

Jenners work influenced many others including Louis Pasteur who developed vaccines against rabies and other infectious diseases

Ignas Semmelweis (1840rsquos)

Pioneered handwashing to help prevent the spread of septic infections in mothers following birth

John Snow (1813-1858)

Father of epidemiology

Careful mapping of cholera cases in East London during cholera epidemic of 1854

Traced source to a single well on Broad Street that had been contaminated by sewage

History of Epidemiology (Contrsquod)

bull Vital Statistics John Graunt (1620-1674) William Farr (1807-1883)

bull Occupational medicineamp Industrial Hygiene

Bernardino Ramazzini (1633-1714)

bull Role of carriers in transmission Typhoid Mary amp George Soper

Typhoid Mary amp George Soper Mary Mallon a cook responsible for most famous outbreaks of

carrier-borne disease in medical history Recognized as carrier during 1904 NY typhoid fever epidemic When source of disease was traced Mary had disappeared

only to resurface in 1907 when more cases occurred Again Mary fled but authorities led by George Soper caught

her and had her quarantined on an island In 1910 the health department released her on condition that

she never accept employment involving the handling of food Four years later Soper began looking for Mary again when two

new epidemics broke out Mary had worked as a cook at both places

She was found and returned to North Brother Island where she remained the rest of her life until a paralytic stroke in 1932 led to her slow death six years later

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

James Lind (1700rsquos)

Designed first experiments to use a concurrently treated control group

Edward Jenner (1749-1823)

Pioneered clinical trials for vaccination to control spread of smallpox

Jenners work influenced many others including Louis Pasteur who developed vaccines against rabies and other infectious diseases

Ignas Semmelweis (1840rsquos)

Pioneered handwashing to help prevent the spread of septic infections in mothers following birth

John Snow (1813-1858)

Father of epidemiology

Careful mapping of cholera cases in East London during cholera epidemic of 1854

Traced source to a single well on Broad Street that had been contaminated by sewage

History of Epidemiology (Contrsquod)

bull Vital Statistics John Graunt (1620-1674) William Farr (1807-1883)

bull Occupational medicineamp Industrial Hygiene

Bernardino Ramazzini (1633-1714)

bull Role of carriers in transmission Typhoid Mary amp George Soper

Typhoid Mary amp George Soper Mary Mallon a cook responsible for most famous outbreaks of

carrier-borne disease in medical history Recognized as carrier during 1904 NY typhoid fever epidemic When source of disease was traced Mary had disappeared

only to resurface in 1907 when more cases occurred Again Mary fled but authorities led by George Soper caught

her and had her quarantined on an island In 1910 the health department released her on condition that

she never accept employment involving the handling of food Four years later Soper began looking for Mary again when two

new epidemics broke out Mary had worked as a cook at both places

She was found and returned to North Brother Island where she remained the rest of her life until a paralytic stroke in 1932 led to her slow death six years later

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Edward Jenner (1749-1823)

Pioneered clinical trials for vaccination to control spread of smallpox

Jenners work influenced many others including Louis Pasteur who developed vaccines against rabies and other infectious diseases

Ignas Semmelweis (1840rsquos)

Pioneered handwashing to help prevent the spread of septic infections in mothers following birth

John Snow (1813-1858)

Father of epidemiology

Careful mapping of cholera cases in East London during cholera epidemic of 1854

Traced source to a single well on Broad Street that had been contaminated by sewage

History of Epidemiology (Contrsquod)

bull Vital Statistics John Graunt (1620-1674) William Farr (1807-1883)

bull Occupational medicineamp Industrial Hygiene

Bernardino Ramazzini (1633-1714)

bull Role of carriers in transmission Typhoid Mary amp George Soper

Typhoid Mary amp George Soper Mary Mallon a cook responsible for most famous outbreaks of

carrier-borne disease in medical history Recognized as carrier during 1904 NY typhoid fever epidemic When source of disease was traced Mary had disappeared

only to resurface in 1907 when more cases occurred Again Mary fled but authorities led by George Soper caught

her and had her quarantined on an island In 1910 the health department released her on condition that

she never accept employment involving the handling of food Four years later Soper began looking for Mary again when two

new epidemics broke out Mary had worked as a cook at both places

She was found and returned to North Brother Island where she remained the rest of her life until a paralytic stroke in 1932 led to her slow death six years later

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Ignas Semmelweis (1840rsquos)

Pioneered handwashing to help prevent the spread of septic infections in mothers following birth

John Snow (1813-1858)

Father of epidemiology

Careful mapping of cholera cases in East London during cholera epidemic of 1854

Traced source to a single well on Broad Street that had been contaminated by sewage

History of Epidemiology (Contrsquod)

bull Vital Statistics John Graunt (1620-1674) William Farr (1807-1883)

bull Occupational medicineamp Industrial Hygiene

Bernardino Ramazzini (1633-1714)

bull Role of carriers in transmission Typhoid Mary amp George Soper

Typhoid Mary amp George Soper Mary Mallon a cook responsible for most famous outbreaks of

carrier-borne disease in medical history Recognized as carrier during 1904 NY typhoid fever epidemic When source of disease was traced Mary had disappeared

only to resurface in 1907 when more cases occurred Again Mary fled but authorities led by George Soper caught

her and had her quarantined on an island In 1910 the health department released her on condition that

she never accept employment involving the handling of food Four years later Soper began looking for Mary again when two

new epidemics broke out Mary had worked as a cook at both places

She was found and returned to North Brother Island where she remained the rest of her life until a paralytic stroke in 1932 led to her slow death six years later

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

John Snow (1813-1858)

Father of epidemiology

Careful mapping of cholera cases in East London during cholera epidemic of 1854

Traced source to a single well on Broad Street that had been contaminated by sewage

History of Epidemiology (Contrsquod)

bull Vital Statistics John Graunt (1620-1674) William Farr (1807-1883)

bull Occupational medicineamp Industrial Hygiene

Bernardino Ramazzini (1633-1714)

bull Role of carriers in transmission Typhoid Mary amp George Soper

Typhoid Mary amp George Soper Mary Mallon a cook responsible for most famous outbreaks of

carrier-borne disease in medical history Recognized as carrier during 1904 NY typhoid fever epidemic When source of disease was traced Mary had disappeared

only to resurface in 1907 when more cases occurred Again Mary fled but authorities led by George Soper caught

her and had her quarantined on an island In 1910 the health department released her on condition that

she never accept employment involving the handling of food Four years later Soper began looking for Mary again when two

new epidemics broke out Mary had worked as a cook at both places

She was found and returned to North Brother Island where she remained the rest of her life until a paralytic stroke in 1932 led to her slow death six years later

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

History of Epidemiology (Contrsquod)

bull Vital Statistics John Graunt (1620-1674) William Farr (1807-1883)

bull Occupational medicineamp Industrial Hygiene

Bernardino Ramazzini (1633-1714)

bull Role of carriers in transmission Typhoid Mary amp George Soper

Typhoid Mary amp George Soper Mary Mallon a cook responsible for most famous outbreaks of

carrier-borne disease in medical history Recognized as carrier during 1904 NY typhoid fever epidemic When source of disease was traced Mary had disappeared

only to resurface in 1907 when more cases occurred Again Mary fled but authorities led by George Soper caught

her and had her quarantined on an island In 1910 the health department released her on condition that

she never accept employment involving the handling of food Four years later Soper began looking for Mary again when two

new epidemics broke out Mary had worked as a cook at both places

She was found and returned to North Brother Island where she remained the rest of her life until a paralytic stroke in 1932 led to her slow death six years later

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Typhoid Mary amp George Soper Mary Mallon a cook responsible for most famous outbreaks of

carrier-borne disease in medical history Recognized as carrier during 1904 NY typhoid fever epidemic When source of disease was traced Mary had disappeared

only to resurface in 1907 when more cases occurred Again Mary fled but authorities led by George Soper caught

her and had her quarantined on an island In 1910 the health department released her on condition that

she never accept employment involving the handling of food Four years later Soper began looking for Mary again when two

new epidemics broke out Mary had worked as a cook at both places

She was found and returned to North Brother Island where she remained the rest of her life until a paralytic stroke in 1932 led to her slow death six years later

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Typhoid Mary

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

US History of Epidemiologybull Lemuel Shattuck (1850)

Proposed creation of a permanent statewide public health infrastructure

Recommended establishing state amp local health offices to gather statistical information on public health conditions

bull Quarantine Commissions (1857)bull 1st Public Health Book (1879)bull US Public Health Service founded (1902)bull Pure Food and Drug Act (1906)bull Pasteurization of milk (1913)bull 1st School of Public Health (1913)

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Historic Aspects of the Development of Morbidity

Statistics in the US

bull Edgar Sydenstricker (Early 1900rsquos) Pioneer public health statistician

bull Three notable studiesTuskegee syphilis study (1932-1970)Framingham heart study (1948-present)Epidemiology of cigarette smoking

(1950rsquos - present)

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Modern History of Epidemiology in the US

bull Mortality stats in first half of centuryUnstable because of outbreaks of infection

bull Stats reversed by 1950rsquos because of childhood immunizations medical interventions and public health measures

bull Economic growth reduced squalor

bull Introduction of antibiotics in 50rsquos

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Wake-up Callsbull Over-optimism in 60rsquos and 70rsquos

bull AIDS recognized

bull Cholera in the southern hemisphere

bull Legionnairersquos disease

bull New forms of hepatitis

bull Chlamydia and heart disease

bull Hospital acquired infections

bull Antibiotic resistance

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

USMortality Index (annual deaths100000)

bull 1900 - 500

bull 1918-1919- 850

bull Mid-century-1982 - 30

bull 1982-1994 - 60

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Future Challenges

bull Instant global transmission of pathogensPopulation overcrowdingEase of travelImportation of foods

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

DEFINITIONS

bull What is epidemiology

bull What is an epidemiologist

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

EPIDEMIOLOGY is the study of the nature cause control

and determinants of the frequency and distribution of disease disability and death

in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention

and control of disease in a defined population

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities

needed for successful epidemiology practice

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Methods of Epidemiology

bull Public Health Surveillance

bull Disease Investigation

bull Analytic Studies

bull Program Evaluation

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Terminology

bull Endemicbull Hyperendemicbull Holoendemicbull Epidemicbull Pandemicbull Epizooticbull Incidencebull Prevalence

Terms used for reference to various forms of

outbreaks

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Endemic a disease or pathogen present or usually prevalent in a given population or geographic region at all times

Hyperendemic equally endemic in all age groups of a population

Holoendemic endemic in most of the children in a population with the adults in the same population being less often affected

Epidemic a disease occuring suddenly in numbers far exceeding those attributable to endemic disease occuring suddenly in numbers clearly in access of normal expectancy

Pandemic a widespread epidemic distributed or occuring widely throughout a region country continent or globally

Epizootic of or related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region

Incidence rate of occurrence of an event number of new cases of disease occuring over a specified period of time may be expressed per a known population size

Prevalence number of cases of disease occurring within a population at any one given point in time

Terms Associated with Disease Causation etc

bull Hostbull Agentbull Environmentbull Fomitesbull Vector bull Carrier ndash activebull Incubatorybull Convalescentbull Healthybull Intermittent

Your Assignment Define these terms

Changing Patterns of Community Health

bull Health patterns in constant state of flux

bull Infectious versus chronic diseases

bull Population and age-related

Chain of Infection

bull Etiological agent

bull SourceReservoir

bull Portal of exit

bull Mode of transmission

bull Portal of entry

bull Susceptible host

bull Virusesbull bullRNAndashDNAbull bull RNA viruses genetically unstablebull bullLipid envelopedndashnonenvelopedbull bull Solvent-detergent treatments virucidal only for enveloped viruses

bull Bacteriabull bullGram-positivendashgram-negativebullAntibiotic sensitivity differsbull bull Diagnostic and therapeutic uses of gram-negative capsule

bull Fungi bullDisseminated vs superficial bullMold vs biphasic

bull Parasitesbull bullComplete cyclebull bullLarval migrans

bull Prionsbull bullPathogenesis unclearbull bullResistant to disinfection

Classification of Microorganisms

A Clinicianrsquos View

bull Diseases classified according to signs and symptoms1 Diarrheal diseases2 Respiratory diseases3 Cutaneoussoft tissue infection4 CNS diseases5 Septicemic diseases6 Fever of undetermined origin

Modes of Transmission

bull Contact transmission

bull Vehicle transmission

bull Vector transmission

An Epidemiologistrsquos ViewMeans of Spread of Infectious Diseases

bull ContactbullDirect

bull bullIndirectbullFomitesbull bull Body secretions (blood urine saliva etc)

bull VectorAirborne

bull bullSmall-particle aerosol

Some Infectious Diseases Spread by Contact

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

Some Important Food- and Waterborne Infections

Some Important Airborne Infections

bull 1 Tuberculosisbull 2 Influenzabull 3 Childhood Infections

minus Measles mumps rubella pertussis

bull 4 Parainfluenzabull 5 RSVbull 6 Legionella

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Changing Patterns of Community Health

bull Health patterns in constant state of flux

bull Infectious versus chronic diseases

bull Population and age-related

Chain of Infection

bull Etiological agent

bull SourceReservoir

bull Portal of exit

bull Mode of transmission

bull Portal of entry

bull Susceptible host

bull Virusesbull bullRNAndashDNAbull bull RNA viruses genetically unstablebull bullLipid envelopedndashnonenvelopedbull bull Solvent-detergent treatments virucidal only for enveloped viruses

bull Bacteriabull bullGram-positivendashgram-negativebullAntibiotic sensitivity differsbull bull Diagnostic and therapeutic uses of gram-negative capsule

bull Fungi bullDisseminated vs superficial bullMold vs biphasic

bull Parasitesbull bullComplete cyclebull bullLarval migrans

bull Prionsbull bullPathogenesis unclearbull bullResistant to disinfection

Classification of Microorganisms

A Clinicianrsquos View

bull Diseases classified according to signs and symptoms1 Diarrheal diseases2 Respiratory diseases3 Cutaneoussoft tissue infection4 CNS diseases5 Septicemic diseases6 Fever of undetermined origin

Modes of Transmission

bull Contact transmission

bull Vehicle transmission

bull Vector transmission

An Epidemiologistrsquos ViewMeans of Spread of Infectious Diseases

bull ContactbullDirect

bull bullIndirectbullFomitesbull bull Body secretions (blood urine saliva etc)

bull VectorAirborne

bull bullSmall-particle aerosol

Some Infectious Diseases Spread by Contact

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

Some Important Food- and Waterborne Infections

Some Important Airborne Infections

bull 1 Tuberculosisbull 2 Influenzabull 3 Childhood Infections

minus Measles mumps rubella pertussis

bull 4 Parainfluenzabull 5 RSVbull 6 Legionella

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Chain of Infection

bull Etiological agent

bull SourceReservoir

bull Portal of exit

bull Mode of transmission

bull Portal of entry

bull Susceptible host

bull Virusesbull bullRNAndashDNAbull bull RNA viruses genetically unstablebull bullLipid envelopedndashnonenvelopedbull bull Solvent-detergent treatments virucidal only for enveloped viruses

bull Bacteriabull bullGram-positivendashgram-negativebullAntibiotic sensitivity differsbull bull Diagnostic and therapeutic uses of gram-negative capsule

bull Fungi bullDisseminated vs superficial bullMold vs biphasic

bull Parasitesbull bullComplete cyclebull bullLarval migrans

bull Prionsbull bullPathogenesis unclearbull bullResistant to disinfection

Classification of Microorganisms

A Clinicianrsquos View

bull Diseases classified according to signs and symptoms1 Diarrheal diseases2 Respiratory diseases3 Cutaneoussoft tissue infection4 CNS diseases5 Septicemic diseases6 Fever of undetermined origin

Modes of Transmission

bull Contact transmission

bull Vehicle transmission

bull Vector transmission

An Epidemiologistrsquos ViewMeans of Spread of Infectious Diseases

bull ContactbullDirect

bull bullIndirectbullFomitesbull bull Body secretions (blood urine saliva etc)

bull VectorAirborne

bull bullSmall-particle aerosol

Some Infectious Diseases Spread by Contact

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

Some Important Food- and Waterborne Infections

Some Important Airborne Infections

bull 1 Tuberculosisbull 2 Influenzabull 3 Childhood Infections

minus Measles mumps rubella pertussis

bull 4 Parainfluenzabull 5 RSVbull 6 Legionella

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

bull Virusesbull bullRNAndashDNAbull bull RNA viruses genetically unstablebull bullLipid envelopedndashnonenvelopedbull bull Solvent-detergent treatments virucidal only for enveloped viruses

bull Bacteriabull bullGram-positivendashgram-negativebullAntibiotic sensitivity differsbull bull Diagnostic and therapeutic uses of gram-negative capsule

bull Fungi bullDisseminated vs superficial bullMold vs biphasic

bull Parasitesbull bullComplete cyclebull bullLarval migrans

bull Prionsbull bullPathogenesis unclearbull bullResistant to disinfection

Classification of Microorganisms

A Clinicianrsquos View

bull Diseases classified according to signs and symptoms1 Diarrheal diseases2 Respiratory diseases3 Cutaneoussoft tissue infection4 CNS diseases5 Septicemic diseases6 Fever of undetermined origin

Modes of Transmission

bull Contact transmission

bull Vehicle transmission

bull Vector transmission

An Epidemiologistrsquos ViewMeans of Spread of Infectious Diseases

bull ContactbullDirect

bull bullIndirectbullFomitesbull bull Body secretions (blood urine saliva etc)

bull VectorAirborne

bull bullSmall-particle aerosol

Some Infectious Diseases Spread by Contact

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

Some Important Food- and Waterborne Infections

Some Important Airborne Infections

bull 1 Tuberculosisbull 2 Influenzabull 3 Childhood Infections

minus Measles mumps rubella pertussis

bull 4 Parainfluenzabull 5 RSVbull 6 Legionella

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

A Clinicianrsquos View

bull Diseases classified according to signs and symptoms1 Diarrheal diseases2 Respiratory diseases3 Cutaneoussoft tissue infection4 CNS diseases5 Septicemic diseases6 Fever of undetermined origin

Modes of Transmission

bull Contact transmission

bull Vehicle transmission

bull Vector transmission

An Epidemiologistrsquos ViewMeans of Spread of Infectious Diseases

bull ContactbullDirect

bull bullIndirectbullFomitesbull bull Body secretions (blood urine saliva etc)

bull VectorAirborne

bull bullSmall-particle aerosol

Some Infectious Diseases Spread by Contact

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

Some Important Food- and Waterborne Infections

Some Important Airborne Infections

bull 1 Tuberculosisbull 2 Influenzabull 3 Childhood Infections

minus Measles mumps rubella pertussis

bull 4 Parainfluenzabull 5 RSVbull 6 Legionella

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Modes of Transmission

bull Contact transmission

bull Vehicle transmission

bull Vector transmission

An Epidemiologistrsquos ViewMeans of Spread of Infectious Diseases

bull ContactbullDirect

bull bullIndirectbullFomitesbull bull Body secretions (blood urine saliva etc)

bull VectorAirborne

bull bullSmall-particle aerosol

Some Infectious Diseases Spread by Contact

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

Some Important Food- and Waterborne Infections

Some Important Airborne Infections

bull 1 Tuberculosisbull 2 Influenzabull 3 Childhood Infections

minus Measles mumps rubella pertussis

bull 4 Parainfluenzabull 5 RSVbull 6 Legionella

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

An Epidemiologistrsquos ViewMeans of Spread of Infectious Diseases

bull ContactbullDirect

bull bullIndirectbullFomitesbull bull Body secretions (blood urine saliva etc)

bull VectorAirborne

bull bullSmall-particle aerosol

Some Infectious Diseases Spread by Contact

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

Some Important Food- and Waterborne Infections

Some Important Airborne Infections

bull 1 Tuberculosisbull 2 Influenzabull 3 Childhood Infections

minus Measles mumps rubella pertussis

bull 4 Parainfluenzabull 5 RSVbull 6 Legionella

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Some Infectious Diseases Spread by Contact

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

Some Important Food- and Waterborne Infections

Some Important Airborne Infections

bull 1 Tuberculosisbull 2 Influenzabull 3 Childhood Infections

minus Measles mumps rubella pertussis

bull 4 Parainfluenzabull 5 RSVbull 6 Legionella

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

bull Salmonellosisbull 2 Campylobacterbull 3 Shigellosisbull 4 Clostridium perfringens food

poisoningbull 5 Staphylococcal enterotoxin food

poisoningbull 6 Cholerabull 7 Giardiasisbull 8 Listeriosis

Some Important Food- and Waterborne Infections

Some Important Airborne Infections

bull 1 Tuberculosisbull 2 Influenzabull 3 Childhood Infections

minus Measles mumps rubella pertussis

bull 4 Parainfluenzabull 5 RSVbull 6 Legionella

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Some Important Airborne Infections

bull 1 Tuberculosisbull 2 Influenzabull 3 Childhood Infections

minus Measles mumps rubella pertussis

bull 4 Parainfluenzabull 5 RSVbull 6 Legionella

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

bull 1 Malariabull 2 Viral encephalitis

minus SLE WEE EE VE California virus

bull 3 Schistosomiasisbull 4 Tularemiabull 5 Denguebull 6 Yellow feverbull 7 Rocky Mountain spotted feverbull 8 Leishmaniasisbull 9 Trypanosomiasis

Some Important Vectorborne Infections

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

bull 1 Human

bull 2 Animal (zoonoses)

bull 3 Soil

bull 4 Water

Reservoirs of Infectious Diseases

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Some Infectious Diseases with a Human Reservoir

bull 1 AIDS (HIV infection)

bull 2 Syphilis

bull 3 Gonorrhea

bull 4 Shigellosis

bull 5 Typhoid fever

bull 6 Hepatitis-B virus

bull 7 Herpes simplex virus

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Some Diseases with an Animal Reservoir (Zoonoses)

bull 1 Nontyphoidal salmonellosis

bull 2 Brucellosis

bull 3 Anthrax

bull 4 Listeriosis

bull 5 Viral encephalitis (SLEWEE CEE)

bull 6 Rabies

bull 7 Plague

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Some Important Diseases with a Soil Reservoir

bull 1 Histoplasmosis

bull 2 Coccidioidomycosis

bull 3 Blastomycosis

bull 4 Tetanus

bull 5 Botulism

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Some Infectious Diseases with a Water Reservoir

bull 1 Pseudomonas infectionsminus Sepsis UTI ldquohot tubrdquo folliculitis

bull 2 Legionnairesrsquo disease

bull 3 Melioidosis

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

bull Sexually transmitted diseasesminus Syphilis gonorrhea chlamydia AIDS

bull 2 Staphylococcal infectionsbull 3 Streptococcal infectionsbull 4 Many nosocomial infectionsbull 5 Rhinovirus coldsbull 6 Brucellosis (slaughter house contact)bull 7 Hepatitis B virus infection

Some Infectious Diseases Spread by Contact

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Classes of Epidemics

bull Common source (vs sporadic)

Point sourceIntermittent ContinuousPropagated

Your Assignment Define these terms

amp identify which apply to the following

three graphs

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

bull 1 Infectivity minus The propensity for transmission minus Measured by the secondary attack rate in a household

school etc

bull 2 Pathogenicity minus The propensity for an agent to cause disease or clinical

symptoms minus Measured by the apparent inapparent infection ratio

bull 3 Virulence minus The propensity for an agent to cause severe disease minus Measured by the case fatality ratio

Infectious Agents 3 Important Epidemiologic Properties

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Infectious Agents 3 Important Epidemiologic Properties

Incubation period = The period between exposure to the agent and onset of infection (with symptoms or signs of infection)

Secondary attack rates = The rates of infection among exposed susceptibles after exposure to an index case such as in a household or school

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

1048708Inapparent(or subclinical infection)minus An infection with no clinical symptoms usually diagnosed by serological (antibody) response or culture

1048708Immunityminus The capacity of a person when exposed to an infectious agent to remain free of infection or clinical illness

1048708Herd immunityminus The immunity of a group or community The resistance of a group to invasion and spread of an infectious agent based upon the resistance to infection of a high proportion of individual members of the group The resistance is a product of the number of susceptibles and the probability that those who are susceptible will come into contact with an infected person

Definitions of Some Relevant Terms (cont)

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

1048708Persistent infectionminus A chronic infection with continued low-grade survival and multiplication of the agent

1048708Latent infectionminus An infection with no active multiplication of the agent as when viral nucleic acid is integrated into the nucleus of a cell as a provirus In contrast to a persistent infection only the genetic message is present in the host not viable organisms

Definitions of Some Relevant Terms (cont)

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Disease Investigation

bull Establish diagnosis

bull Identify specific agent

bull Describe according to person place and time

bull Identify source of agent

bull Identify mode of transmission

bull Identify susceptible populations

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Epidemiology and Clinical Practice

bull Clinical practice dependent on epidemiology

bull Epidemiology defines natural history of disease

bull Even descriptive information is useful

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

The Epidemiologic Approach

bull Multistep process

bull First - determine association

bull Then prove causation

bull Not all associations are causal

bull Examine validity false assumptions-eg - fluoride in water

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Analytic Studies

bull Type of study

bull Design

bull Analysis of data

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Epidemiology and Prevention

bull Identify high risk populations

bull Modify risks

bull Prevent exposures

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Levels of Prevention

bull Primary

bull Secondary

bull Tertiary

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Levels of Prevention (contrsquod)

bull Primary

Involves halting any occurrence of a disease or disorder before it happens

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Levels of Prevention (contrsquod)

bull Secondary

Health screening and detection activities

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59

Levels of Prevention (contrsquod)

bull Tertiary

Retard or block the progression of condition

• MEDICINE AND PHARMACY FACULTY UNIVERSITY OF ORADEA EPIDEMIOLOGY By CONSTANTA TURDA MD
• History of Epidemiology
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• History of Epidemiology (Contrsquod)
• Slide 10
• Slide 11
• US History of Epidemiology
• Historic Aspects of the Development of Morbidity Statistics in the US
• Modern History of Epidemiology in the US
• Wake-up Calls
• USMortality Index (annual deaths100000)
• Future Challenges
• DEFINITIONS
• EPIDEMIOLOGY is the study of the nature cause control and determinants of the frequency and distribution of disease disability and death in human populations Epidemiology the study of factors influencing the occurence transmission distribution prevention and control of disease in a defined population
• An EPIDEMIOLOGIST is a public health scientist who is responsible for carrying out all useful and effective activities needed for successful epidemiology practice
• Slide 21
• Slide 22
• Methods of Epidemiology
• Terminology
• Slide 25
• Slide 26
• Terms Associated with Disease Causation etc
• Changing Patterns of Community Health
• Chain of Infection
• Slide 30
• Classification of Microorganisms
• A Clinicianrsquos View
• Modes of Transmission
• Slide 34
• An Epidemiologistrsquos View Means of Spread of Infectious Diseases
• Some Infectious Diseases Spread by Contact
• Some Important Food- and Waterborne Infections
• Some Important Airborne Infections
• Some Important Vectorborne Infections
• Reservoirs of Infectious Diseases
• Some Infectious Diseases with a Human Reservoir
• Some Diseases with an Animal Reservoir (Zoonoses)
• Some Important Diseases with a Soil Reservoir
• Some Infectious Diseases with a Water Reservoir
• Slide 45
• Classes of Epidemics
• Infectious Agents 3 Important Epidemiologic Properties
• Slide 48
• Definitions of Some Relevant Terms (cont)
• Slide 50
• Disease Investigation
• Epidemiology and Clinical Practice
• The Epidemiologic Approach
• Analytic Studies
• Epidemiology and Prevention
• Levels of Prevention
• Levels of Prevention (contrsquod)
• Slide 58
• Slide 59